title: First experiences with a new adjustable plate for osteosynthesis of scaphoid nonunions.
abstract: BACKGROUND
  Plate osteosynthesis of the scaphoid, as reported earlier by Ender, has lost its importance in the past few years, after Herbert's introduction of the simple and successful technique of screw osteosynthesis. Only in rare cases does one encounter failed healing or instability of the fragments. Even with a vascularized bone chip, it is not always possible to achieve consolidation. Particularly in these situations, poor interfragmentary stability seems to be the reason for failed healing.
  
  
  METHODS
  Between January 2007 and August 2009, we treated 7 men and 4 women of mean age 37 years (22-53 years) by scaphoid plate osteosynthesis. All the patients had fractures of the waist of the scaphoid with established nonunion persisting for at least 6 months after the causative injury, with wrist pain, weakness, or both. All 11 patients had clinical and radiologic follow-up for at least 6 months.
  
  
  RESULTS
  All the fractures united at a median time from operation of ∼4 months. All patients reported an improvement in their symptoms and function. The mean DASH score was 28 points.
  
  
  CONCLUSIONS
  Scaphoid plate osteosynthesis should be regarded as a salvage procedure, and the indication for the procedure should be established accordingly. It is a simple procedure in terms of technique. The plate can be adjusted very well to the anatomic shape of the scaphoid, and one can achieve a high degree of stability, particularly rotational stability.
authors.affiliation: Department of Traumatology, Trauma Hospital Lorenz Boehler, Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Leixnering
authors.forename: Christoph
authors.initials: C
authors.lastname: Pezzei
authors.forename: Patrick
authors.initials: P
authors.lastname: Weninger
authors.forename: Michael
authors.initials: M
authors.lastname: Mayer
authors.forename: Robert
authors.initials: R
authors.lastname: Bogner
authors.forename: Stefan
authors.initials: S
authors.lastname: Lederer
authors.forename: Josef
authors.initials: J
authors.lastname: Schauer
authors.forename: Markus
authors.initials: M
authors.lastname: Figl
mesh_terms: D000328:Adult; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D021361:Scaphoid Bone / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult